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Gathering information from an owner before seeing an emergency is key. It’s especially important for the equine veterinarian. With the exception of those who work at large hospitals or clinics with a haul-in facility, we are bringing the ER to you! Stocked in our truck is most all of the equipment we could possibly need for an emergency, bandages, suture, sedation, antibiotics, you name it, we’ve tried to find a spot for it. But some tools that we may need might not live in our vehicles. Ultrasound and radiograph (x-ray) machines may be too big and take up too much room to always be in the truck, or we have to share it amongst our coworkers. Certain drugs that have a short shelf life, or are not used on a regular basis may not always be at our fingertips. Therefore before we come out to see your emergency, we may need to swing by the office and pick up a few supplies. And that is why it is so important for us to gather as much information about the case before we hit the road.  It’s not that we don’t think it’s an emergency, or our secretary is just trying to make idle chit-chat, we need all the details we can get so we will be prepared. And I’ve learned that to get that info, you need to ask the right questions. Don’t ask, “Did you give your horse any medications today?” ask, “Did you give any Bute or Banamine,” as those meds are so common place in today's barns that owners may not even think to mention them, like if you went to your doctor and the nurse asked you what medications you were on, you may not even think to mention the two aspirin you took for that headache this morning. And as much as it’s our job to ask the right questions, it’s your job, as the owner/trainer/caretaker to give the right answers (to the best of your ability of course). And I want to make sure your ability is at its best! 

It happens more often than we’d like, usually when we’re talking about lacerations, that an owner describes one thing, and you find something entirely different when you reach the farm. This difference may mean that we would have prepared differently or brought different equipment with us. The confusion is usually due to terminology. There are many different names for all the parts of a horse, from the fancy Latin phrase to the layman’s term. Using the same vocabulary can help us (the vet) communicate with you (the owner) to take better care of them (our horses). Having a common language will lead to more efficient and effective communication and better care for your horse!

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Directions of the horse.

TOP TO BOTTOM

Dorsal: Near the topline or back. Think dorsal fin on a shark. 

If you run your hand down the middle of your horse’s back, you are touching the dorsal midline. The withers are dorsal to the shoulder.  

Ventral: The bottom or towards the belly. A horse that has colic surgery will have an incision made on the ventral midline. The udder is on the ventral abdomen.


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These terms apply to dogs too!

FRONT TO BACK

Cranial: Towards the head (or the cranium). The point of the hip is cranial to the tail. 

Caudal: Towards the tail. You place the saddle caudal to the horse’s neck.

Now when we’re talking about the head you’re already as cranial as you can be so you really can’t say something is more cranial than something else on the cranium. 

Rostral: Towards the tip of the nose. The nostrils are more rostral than the eyes. 

Just because we like to make it confusing, terms change when we talk about things below the knees and the hocks.

We still use dorsal to indicate the front of the limbs. But for the back of the legs we use palmar and plantar (depending on if it’s a front of back leg):

Palmar: front legs. Like our hands have palms. The flexor tendons run down the palmar surface of the front leg.

Plantar: back legs. Like we get plantar fasciitis in our hind limbs (our feet). The ergot is on the plantar surface of the hind fetlocks.

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NOT a horse, but a great diagram!

SIDE TO SIDE

Lateral: Towards the side, away from midline, the outside. The ear is lateral to the forelock.

Medial: Towards midline, the inside. The chestnut is on the medial side of the leg.

NEAR AND FAR

Proximal: Closer to the origin (the body). The knee is proximal to the foot.

Distal: Away from the origin (body). Think distal=distant. The fetlock is distal to the knee.


THIS AND THAT

With horses having so many appendages, we sometimes have to describe a location in relation to the first location and it can either be on the same side or the opposite side. These are much less commonly used terms;

Contralateral: The opposite side of the horse. A horse with a broken leg it at risk of developing contralateral limb laminitis after putting too much weight on the good leg.

Ipsilateral: The same side of the horse. When the horse fell on its side, it injured the right eye and the ipsilateral shoulder (the right shoulder).
 
 
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The old saying goes, “No hoof, no horse” and truer words have never been spoken. Any horse owner knows that trouble starts from the bottom up and hoof issues can put you on the sidelines for far too long. This is a problem that one of my clients is facing. Her horse is suffering from White Line Disease (WLD) in all four feet and while her farrier and local veterinarian are doing exactly the right things to get her back in the saddle, as a graduate of both the Beginner and Advanced Equine Education Courses she has a thirst for knowledge and asked me for a little more information on the process. And I thought I would share my answer with all of you.     White line disease is a problem of the equine hoof that is seen throughout the world and is still poorly understood by the veterinary and farrier community.  It is characterized by the separation of the inner zone of the hoof wall. This separation that occurs on the solar surface of the hoof can begin at the toe (which is where the old layman’s term “seedy toe” comes from) or the quarter or the heel. The area of separation is then invaded by bacteria and fungus from the environment (remember the separation starts on the bottom of the hoof, which spends most of its time in the dirt). The separation, and infection, can progress proximally up the hoof wall towards the coronary band. Interestingly, the coronary band never becomes infected, which is why the term onychomycosis (a nail bed infection in humans or dogs) is inappropriate to use when describing WLD.

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In vet school I was lucky enough to learn equine orthopedics from Dr. Dean Richardson, the surgeon who cared for Barbaro, and if there is one thing every Penn Vet grad remembers about equine orthopedics, its that you have to know your ANATOMY, ANATOMY, ANATOMY! (though all capital letters cannot truly convey the emotion, or volume, with which DWR screamed this during lectures).
So to understand WLD better, lets review the ANATOMY of the hoof as it pertains to this problem. The Solar Surface of the Hoof     The hoof wall consists of three layers; the stratum tectorium (external layer), the stratum medium (the middle layer), and the stratum lamellatum (the inner layer). The stratum tectorium is the thin layer of cells that give the wall its smooth shiny appearance. The stratum medium forms the bulk of the wall and is the densest part of the hoof wall. The stratum lamellatum arises from the laminae, is nonpigmented, and is responsible for attaching the hoof wall to the third phalanx, and is what gives us so much trouble in cases of laminitis or founder. The junction where the sole attaches to the wall of the hoof is formed by interdigitation of lamellae and horny tubular tissue. This is the area known as the White Line, though in real life it is often yellow in color.

So how does separation occur between the sole and the hoof wall? And the question most owners ask, “Why is this happening to my horse?” While there are a lot of theories out there about what causes WLD, none of them have been confirmed. It can affect horses of any age, sex or breed. It can affect one foot or a combination of all four. Horses with shoes get WLD and barefoot horses get WLD. Horses in every country can be affected and you may have one case on a farm or multiple ones. Mechanical stresses that are constantly being put on the hoof can contribute to the separation and chronic hoof problems and poor conformation may also be a cause.     Some people believe that moisture plays a role because, just like Scratches, it is so often seen in horses that spend time in wet paddocks or show horses who are bathed daily. However, it is also seen in arid climates. Moisture may soften the foot, allowing easier access for bacteria and debris, but hot, dry conditions make hooves prone to cracking, allowing the microbes to invade. And don’t try to blame the housekeeper, because WLD is seen equally in areas of poor hygiene as well as clean, well-managed stables.
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Not all horses that have WLD will become lame. It is often an incidental finding at a routine farrier appointment. However when the separation becomes so extensive that there is destabilization of the whole hoof, horses will become sore. The diagnosis is made by your vet or farrier examining the hoof and investigating if there is a gap between the hoof wall and the inner structures. Radiographs (x-rays) can be very helpful because they show the extent of the damage and if there are any other structural problems with the hoof or the coffin bone.

Treatment involves opening up the spaces by removing the overlying hoof wall (with a dremel tool). Once every cavity is exposed, topical antiseptics can be used judiciously (no more than once or twice a week) to clear up the infection. Afterwards corrective shoeing will help support the hoof while it regrows the resected portions. Acrylic can be applied to the area to prevent recontamination, or for cosmetics, but should only be used once the infection is completely resolved. 

    Because we don’t know the exact cause, it’s difficult to make recommendations on how to prevent WLD. But daily hoof care on your part and proper trimming and shoeing performed by a well-trained farrier is the first step to recognizing a problem early on. Horses that have had WLD should be monitored all the more closely as the can have spontaneous recurrence of the disease.

            So keep your eyes open and your horse’s feet well cared for and you can stay on the trail or in the ring without problems!
 

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